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HUMAN HEALTH AND DISEASE > Psycho-Social I & II > Flashcards

Psycho-Social I & II Flashcards

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1
Q

What is generalised anxiety disorder (GAD)?

A

Long-term condition with feeling of anxiousness about a wide range of situations.

People with GAD feel anxious most days

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2
Q

What are the physical clinical features of GAD?

A

Dizziness, tachycardia, palpitations, diarrhoea, dry mouth, headaches, insomnia.

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3
Q

What are the psychological clinical features of GAD?

A

Aggression, lack of concentration, poor memory, loss of sleep, irritability, feel restless, worried, on edge.

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4
Q

What is a phobia?

A

Irrational fear of an object or situation- triggers severe anxiety

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5
Q

What is panic disorder?

A

Episodes of intense anxiety or panic.

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6
Q

What is OCD?

A

Recurring thoughts leading to need to repeatedly perform certain acts

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7
Q

What is PTSD?

A

Anxiety caused by stressful, frightening or distressing events

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8
Q

What is social anxiety disorder?

A

Fear of social situations

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9
Q

What is depression and describe its incidence & lifetime expectancy?

A

Sustained depression of mood
Affects up to 400/100,000 per year
Lifetime expectancy 10-20%
F>M 2 : 1

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10
Q

What are the clinical features of depression?

A

Sustained lowering of mood
Loss of appetite
Early morning waking
Lack of energy
Loss of concentration
Reduced libido
Anhedonia (inability to experience pleasure)
Suicidal thoughts

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11
Q

What is bipolar disorder and describe its incidence & lifetime expectancy?

A

Alternating episodes of depression & euphoria
Onset 20-40
Incidence: 20-100,000 per year
Lifetime expectancy 1%
F>M 1.3 : 1

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12
Q

What are the clinical features of bipolar disorder?

A

Episodes of elevation of mood associated with mental & physical overactivity

Bright clothes, over familiar, disinhibition, pressure of speech, flight of ideas, grandiose ideas, risk taking

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13
Q

What is schizophrenia?

A

Psychosis (loss of contact with reality)

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14
Q

What is the lifetime risk of developing schizophrenia?

A

Up to 1%

For those who have a first degree relative affected, it’s around 12%

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15
Q

What is usually the age of onset for schizophrenia?

A

15-35

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16
Q

What are the clinical features of scizophrenia?

A

Hallucinations (perception in absence of reality)- auditory, visual, tactile, gustatory

Delusions (belief in something untrue)- persecutory, grandiose, delusions of reference

Thought disorders- insertion, broadcasting, withdrawal

Others- paranoid beliefs, social withdrawal

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17
Q

What is the treatment for schizophrenia?

A

Anti-psychotic medication
Therapy e.g. CBT

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18
Q

What is an eating disorder?

A

Disturbance in eating behaviour

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19
Q

What is anorexia nervosa?

A

Voluntary reduction in oral intake to reduce body weight
Often also increase in exercise, laxative abuse, vomiting
Anxiety about body shape and weight
Fear of obesity
Disturbance of weight perception- belief that they are overweight

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20
Q

What is the prevalence of anorexia nervosa?

A

2% schoolgirls and affects F>M 20:1
Peak incidence 10-19

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21
Q

What are the signs associated with anorexia nervosa?

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A

Low self-esteem, depression, anxiety

Light-headed, dizziness, amenorrhoea

Risk of suicide 10%

May take several years to fully recove

22
Q

What is bulimia nervosa?

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A

Attempt to control weight by restricting amount they eat, then binge eating and then self-induced vomiting or laxative abuse

Associated with abnormal attitude towards food or body image

Normal body weight or some weight loss

23
Q

Is bulimia more common than anorexia?

24
Q

Who tends to be affected by bulimia?

Study These Flashcards
A

Up to 10% of women aged 20-30 affected

25
What are the signs associated with bulimia nervosa?
Low self-esteem, depression, anxiety, self-harm Social pressure to be slim
26
What is the dental relevance of common psychiatric disorders?
Poor dental attenders Poor oral hygiene Increased risk of smoking, alcohol abuse, illegal drug abuse Antidepressants & anti-psychotics- dry mouth Dental phobia Increased risk of dental & maxillofacial trauma Increased risk of TMJ disorders; chronic orofacial pain
27
What is the dental relevance of common eating disorders?
Dental erosion- esp palatal surfaces of upper incisors Salivary gland enlargement Need to take low body weight into account when calculating drug dosages Increased risk of fainting/postural hypotension
28
What is dementia?
A condition where there is a gradual deterioration of intellect, memory and cognitive function in the absence of a disturbance of consciousness This usually affects older patients >65 yrs
29
What are the potential causes of dementia?
Degenerative disease (Alzheimer's which is responsible for over 70%) Genetic (Huntington's chorea) Vascular (multi-infarct dementia) Metabolic (Wilson's disease) Toxic (Alcohol) Brain lesion - tumour, infection (CJD), inflammation (SLE)
30
What does treatment for dementia include?
Social support
31
What are the clinical features of dementia?
Impaired intellect, memory & concentration Difficulty reading, writing, speaking Personality change
32
What is the dental relevance of a patient having dementia?
Poor oral hygiene Poor attenders
33
What are some risk factors for Alzheimer's?
Increased risk with age, family history, previous head injury, smoking, obesity, diabetes, hypertension, hypercholesterolaemia
34
What behavioural tendencies are associated with Alzheimer's?
Depression Aggressive behaviour Uncooperation
35
What does the treatment for Alzheimer's include?
Drugs (donepezil, acetyl choline esterase inhibitors) Social support
36
What happens in Parkinson's disease?
Degeneration nerve cells in substantia nigra with loss of dopamine (vital role in regulating movement of body)
37
What are some features of Parkinson's disease?
Tremor- at rest, may affect tongue & jaw Rigidity- resistance to passive movements Hypokinesia (slowness of movement)
38
What are some clinical features of Parkinson's?
Postural changes Loss of facial expression Delayed swallowing, drooling Weak voice Depression Insomnia
39
What does the treatment for Parkinson's involve?
Social support Physiotherapy Drugs- levodopa, dopamine agonists
40
What is the dental relevance of having a patient with Parkinson's?
Poor oral hygiene Increased risk of aspiration Difficulty sitting in dental chair Drooling
41
What are the definitions of psychological dependence, physical dependence, and tolerance?
Psychological dependence: A condition in which the drug promotes a feeling of satisfaction and a drive to repeat the consumption of the drug to induce pleasure or avoid discomfort (WHO 1974). Physical dependence: A state that shows itself by physical disturbances when the amount of drug in the body is markedly reduced. The disturbances form a withdrawal or abstinence syndrome composed of somatic and mental symptoms and signs which are characteristic of each drug type (WHO 1974). Tolerance: When markedly increased amounts of the substance are required to achieve the desired effect or there is a markedly diminished effect with regular use of the same dose.
42
What are the oral manifestations of using cannabis and what are the complications?
Dry mouth, oral ulceration with chronic use Complications: -Respiratory complications including lung cancer -Other drugs- tobacco, alcohol -Pregnancy– premature labour, transient, mild effect on baby -Social consequences
43
What are the oral manifestations of using cocaine?
Ulceration esp where held in mouth Oro-nasal fistula
44
What are the oral manifestations of using ecstasy?
Trismus, temporomandibular disorders, dry mouth (Treatment includes rehydration)
45
What are the oral effects of taking qat (khat)?
Plasma cell gingivitis Ulceration Lichenoid reactions
46
What are some examples of complications of IV drug misuse?
Abscesses Thrombophlebitis Arterial spasm Septicaemia, infective endocarditis Hepatitis B,C HIV
47
How does detoxification & rehabilitation work in drug abuse?
Detoxification: Dose reduction: May need substitution eg methadone – opioid agonist to avoid withdrawal symptoms Symptomatic treatment – adjunctive therapy eg IV fluids (ecstasy) May need inpatient treatment. Psychological support important Rehabilitation: -Leaving drug culture / adopting a new life -May need residential rehabilitation/community programme -Needs involvement of patient and family -Factual & practical advice -Counselling -Use of help groups Other needs: Legal Social Medical Psychiatric
48
What are some signs & characteristics of drug abuse?
Characteristics: Poor historians Lying about intake Disproportionate demand for analgesics Good knowledge of formulary Inappropriate fear of needles in hands of others IV access is difficult due to the lack of patent veins Signs: Mood swings Loss of interest in appearance Inappropriate wearing of sunglasses Needle tracks Unusual tattoos over veins
49
How do you recognise a drinking problem in your patients?
Drinking history: Amount consumed in units Time of first alcoholic drink in the day Pattern of drinking Presence of withdrawal symptoms (early morning shakes) Ask CAGE questions: E.g. Have you ever felt you should Cut down on your drinking? Have people Annoyed you by criticising your drinking? Have you ever felt bad or Guilty about your drinking? Do you need an ‘Eye-opener’ first thing in the morning? Answering yes to 2 or more of these questions is clinically significant
50
How might alcohol dependence present?
slide 34
51
How should you manage problem drinking/alcohol dependence?
slide 36
52
What do alcohol withdrawal states include?
Withdrawal syndrome: Onset is 3-6 hrs after last drink Duration is 5-7 days Common symptoms include headaches, nausea & vomiting, sweating, tremor Delirium tremens: Onset is 48-72 hrs after last drink Features include delirium & tremor Complications include fits, hyperthermia, dehydration, shock Mortality is high- up to 10%

HUMAN HEALTH AND DISEASE (58 decks)

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